Sample Size: The primary outcome is difference in maximal pain level during procedures between the NSS group and the Music/Photo group. Power estimates are based on the magnitude of effect from the bronchoscopy study and the standard deviation of pain ratings in bone marrow biopsies studied by Dr. Grossman. In order to have 80% power to detect a 2-point difference in pain rating using the HPRI with an alpha error level of 0.05 we will need 29 patients in each group (total n=87). We plan to enroll 40 patients in each group (total n=120) to compensate for study withdrawal and missing data. We will continue to enroll patients until we have met these goals.